{
"Npi": {
"NPI": "1689041451",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MONTANARO",
"FirstName": "CHRISTINE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "RAKOWSKY",
"OtherFirstName": "CHRISTINE",
"OtherMiddleName": "MARIE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "NP",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "6435 W JEFFERSON BLVD",
"SecondLineMailingAddress": "PMB 109",
"MailingAddressCityName": "FORT WAYNE",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46804-6203",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "260-344-4035",
"MailingAddressFaxNumber": "260-969-9272",
"FirstLinePracticeLocationAddress": "700 BROADWAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT WAYNE",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46802-1402",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "260-344-4035",
"PracticeLocationAddressFaxNumber": "260-969-9272",
"EnumerationDate": "08/28/2015",
"LastUpdateDate": "06/20/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363LA2200X",
"TaxonomyName": "Adult Health Nurse Practitioner",
"LicenseNumber": "71005710A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "28225101A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}